The effect of cerebral palsy on the action of vecuronium with or without anticonvulsants

Patients with cerebral palsy who are treated with anticonvulsant medication are resistant to vecuronium. We examined the contributions to vecuronium r esistance made by cerebral palsy and anticonvulsants in a study of children with cerebral palsy and a control group. The acceleromyographic responses of the following three groups of children were studied: children with cereb ral palsy not taking anticonvulsant medication (n = 11); children with cere bral palsy taking anticonvulsant medication (n = 8); and a control group of children who did not have cerebral palsy and were not taking anticonvulsan t treatment (n = 10). Using a standardised technique, general anaesthesia w as induced and maintained with 0.5-1.5% isoflurane in a 60/40 nitrous oxide in oxygen mixture. After a stabilisation period which was performed with s upramaximal train-of-four stimuli (2 Hz every 15 s) an intubating dose of v ecuronium 0.1 mg.kg(-1) was administered. The first twitch of the train-of- four response (T-1), the onset time, the times to 25, 50, 75 and 90% recove ry of T-1, recovery index, and the time to 70% recovery of train-of-four ra tio were recorded. Recovery times to T-1 and train-of-four responses were r educed significantly in both groups of children with cerebral palsy compare d with the control group. These results suggest that children with cerebral palsy display resistance to vecuronium whether or not they are taking anti convulsant drugs.